Recent Advances in Magnetic Resonance Imaging Assessment of Renal Fibrosis

Li, Jingya; An, Changlong; Kang, Lijun; Wang, Yanlin

doi:10.1053/j.ackd.2017.03.005

Cited by 17 publications

(21 citation statements)

References 53 publications

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“…Moreover, sampling errors due to the focal nature of renal fibrosis may lead to misinterpretation [ 9 ]. Quantitative magnetic resonance imaging (MRI) approaches, such as mapping techniques and diffusion weighted imaging, could potentially discriminate histological changes in kidneys non-invasively [ 10 – 13 ]. However, until now non-contrast enhanced quantitative MRI parameters for the assessment of histopathological changes in renal tissue have been evaluated in only few experimental studies [ 14 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Multiparametric magnetic resonance imaging of experimental chronic kidney disease: A quantitative correlation study with histology

et al. 2018

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ObjectivesIn human chronic kidney disease (CKD) the extent of renal tubulointerstitial fibrosis correlates with progressive loss of renal function. However, fibrosis can so far only be assessed by histology of kidney biopsies. Magnetic resonance imaging (MRI) can provide information about tissue architecture, but its potential to assess fibrosis and inflammation in diseased kidneys remains poorly defined.Materials and methodsWe evaluated excised kidneys in a murine adenine-induced nephropathy model for CKD by MRI and correlated quantitative MRI parameters (T1, T2, and T2* relaxation times, apparent diffusion coefficient and fractional anisotropy) with histological hallmarks of progressive CKD, including renal fibrosis, inflammation, and microvascular rarefaction. Furthermore, we analyzed the effects of paraformaldehyde fixation on MRI parameters by comparing kidney samples before and after fixation with paraformaldehyde.ResultsIn diseased kidneys T2 and T2* relaxation times, apparent diffusion coefficient and fractional anisotropy in the renal cortex and/or outer medulla were significantly different from those in control kidneys. In particular, T2 relaxation time was the best parameter to distinguish control and CKD groups and correlated very well with the extent of fibrosis, inflammatory infiltrates, tubular dilation, crystal deposition, and loss of peritubular capillaries and normal tubules in the renal cortex and outer medulla. Fixation with paraformaldehyde had no impact on T2 relaxation time and fractional anisotropy, whereas T1 times significantly decreased and T2* times and apparent diffusion coefficients increased in fixed kidney tissue.ConclusionsMRI parameters provide a promising approach to quantitatively assess renal fibrosis and inflammation in CKD. Especially T2 relaxation time correlates well with histological features of CKD and is not influenced by paraformaldehyde fixation of kidney samples. Thus, T2 relaxation time might be a candidate parameter for non-invasive assessment of renal fibrosis in human patients.

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Section: Introductionmentioning

confidence: 99%

Multiparametric magnetic resonance imaging of experimental chronic kidney disease: A quantitative correlation study with histology

et al. 2018

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“…Imaging tests are particularly valuable as they provide information on kidney size, contours, location, and density as well as anatomy of the urinary drainage system (pelvis, ureters and bladder). Specific lesions, such as cysts, dilation of ureters or pelvis, calcification, masses, scars an provide valuable clues to the cause of CKD or even generate a specific diagnosis (such as autosomal dominant polycystic kidney disease or obstructive uropathy) 141 . Then urine sediment examination is important for the detection and quantification of haematuria, leukocyturia and casts.…”

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confidence: 99%

Chronic kidney disease

Romagnani

Remuzzi

Glassock³

et al. 2017

Nat Rev Dis Primers

715

501

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Chronic kidney disease (CKD) is defined by persistent urine abnormalities, structural abnormalities or impaired excretory renal function suggestive of a loss of functional nephrons. The majority of patients with CKD are at risk of accelerated cardiovascular disease and death. For those who progress to end-stage renal disease, the limited accessibility to renal replacement therapy is a problem in many parts of the world. Risk factors for the development and progression of CKD include low nephron number at birth, nephron loss due to increasing age and acute or chronic kidney injuries caused by toxic exposures or diseases (for example, obesity and type 2 diabetes mellitus). The management of patients with CKD is focused on early detection or prevention, treatment of the underlying cause (if possible) to curb progression and attention to secondary processes that contribute to ongoing nephron loss. Blood pressure control, inhibition of the renin-angiotensin system and disease-specific interventions are the cornerstones of therapy. CKD complications such as anaemia, metabolic acidosis and secondary hyperparathyroidism affect cardiovascular health and quality of life, and require diagnosis and treatment.

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“…Recent advances in diagnostic imaging techniques, including MRI and ultrasound elastography, may allow accurate assessment and longitudinal evaluation of kidney fibrosis [31][32][33][34][35][36]. Liu and colleagues [37] used functional MRIs to evaluate interstitial fibrosis in kidney allografts, while Sun et al [36] also used elastin imaging to monitor kidney fibrosis.…”

Section: Discussionmentioning

confidence: 99%

Serum Lysyl Oxidase Is a Potential Diagnostic Biomarker for Kidney Fibrosis

Zhang

Zhou

et al. 2020

Am J Nephrol

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Background: Kidney fibrosis is the ultimate consequence of advanced stages of chronic kidney disease (CKD); however, there are currently no reliable biomarkers or noninvasive diagnostic tests available for the detection of kidney fibrosis. Lysyl oxidase (LOX) promotes collagen cross-linking, and serum LOX levels have been shown to be elevated in patients with fibrosis of the heart, lungs, and liver. However, serum LOX levels have not been reported in patients with kidney fibrosis. We explored whether serum LOX levels are associated with kidney fibrosis. Method: Overall, 202 patients with kidney disease underwent renal biopsy, scoring of kidney fibrosis, and determination of the area of kidney fibrosis. LOX levels were measured in serum and in kidney tissues. We analyzed the association of circulating LOX and tissue LOX levels with the scores and areas of kidney fibrosis. LOX expression was also investigated with in vitro and in vivo kidney fibrosis models. Results: Serum LOX levels were higher in patients with kidney fibrosis than in those without kidney fibrosis (p < 0.001) and higher in patients with moderate-severe kidney fibrosis than in patients with mild kidney fibrosis (p < 0.001). Both serum LOX and renal tissue LOX levels correlated with the area of kidney fibrosis (r = 0.748, p < 0.001; r = 0.899, p < 0.001, respectively). Receiver operating characteristic curve analysis of serum LOX levels showed an area under the curve of 0.80 (95% CI: 0.74–0.86). The optimal serum LOX level cutoff point was 253.34 pg/mL for the prediction of kidney fibrosis and 306.56 pg/mL for the prediction of moderate-severe kidney fibrosis. LOX expression levels were significantly upregulated (2.3–2.6 and 6-fold, respectively) in in vitro and in vivo interstitial fibrosis models. Conclusions: Both serum LOX and tissue LOX levels correlated with the presence and degree of kidney fibrosis in patients with CKD. These results suggest that serum LOX levels could potentially serve as a noninvasive diagnostic biomarker for kidney fibrosis and may further potentially serve as a stratified biomarker for the identification of mild and moderate-severe kidney fibrosis.

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Recent Advances in Magnetic Resonance Imaging Assessment of Renal Fibrosis

Cited by 17 publications

References 53 publications

Multiparametric magnetic resonance imaging of experimental chronic kidney disease: A quantitative correlation study with histology

Multiparametric magnetic resonance imaging of experimental chronic kidney disease: A quantitative correlation study with histology

Chronic kidney disease

Serum Lysyl Oxidase Is a Potential Diagnostic Biomarker for Kidney Fibrosis

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